Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease primarily affecting apocrine gland-rich areas of the body. It is a multifactorial disease in which genetic and environmental factors play a key role. The primary defect in HS pathophysiology involves follicular occlusion of the folliculopilosebaceous unit, followed by follicular rupture and immune responses. Innate pro-inflammatory cytokines (e.g., IL-1β, and TNF-α); mediators of activated T helper (Th)1 and Th17 cells (e.g., IFN-γ, and IL-17); and effector mechanisms of neutrophilic granulocytes, macrophages, and plasma cells are involved. On the other hand, HS lesions contain anti-inflammatory mediators (e.g., IL-10) and show limited activity of Th22 cells. The inflammatory vicious circle finally results in pain, purulence, tissue destruction, and scarring. HS pathogenesis is still enigmatic, and a valid animal model for HS is currently not available. All these aspects represent a challenge for the development of therapeutic approaches, which are urgently needed for this debilitating disease. Available treatments are limited, mostly off-label, and surgical interventions are often required to achieve remission. In this paper, we provide an overview of the current knowledge surrounding HS, including the diagnosis, pathogenesis, treatments, and existing translational studies.
Highlights
Hidradenitis suppurativa (HS), known as acne inversa, is a chronic inflammatory skin disease affecting ~1% of the global population [1]
We provide an overview of the current knowledge surrounding HS, including the diagnosis, pathogenesis, treatments, and translational studies
Insulin, insulin-like growth factor 1 (IGF-1), and branched chain amino acids are found to be increased in red meat and dairy products. They lead to the activation of mammalian target of rapamycin, whose expression was found to be increased in HS lesions compared to non-HS lesions in a previous study [53]
Summary
Hidradenitis suppurativa (HS), known as acne inversa, is a chronic inflammatory skin disease affecting ~1% of the global population [1]. One third of patients are genetically predisposed [3]. Lifestyle factors, such as smoking and obesity, play a crucial role in the clinical course of HS [4,5,6]. Due to its chronic nature and frequently occurring relapses, HS has a great impact on the patients’ quality of life, deeply affecting social, working, and psychological aspects [2,7,8,9]. Early diagnosis is very important for HS patients in order to ensure the best possible course of this stigmatizing and painful disease. Overview of the current knowledge surrounding HS, including the diagnosis, pathogenesis, treatments, and translational studies
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